New focus on medication management in a correctional setting has surfaced in an issue paper published in May 2018 by the Community Oriented Correctional Health Services (COCHS). Authored by Ben Butler, the chief information officer, the publication not only highlights areas where improvement is needed but also emphasizes opportunities for advancing the organization’s goals of enhancing healthcare delivery in a financially viable and sustainable manner. Butler notes that in most cases, incarcerated individuals cannot contact their primary care providers and cannot even self-administer medications, leaving the correctional facility responsible for the entire medication-management process.
COCHS is a nonprofit organization that works to connect and strengthen collaborative partnerships between jails and community healthcare providers with the goal of establishing medical homes for offenders in the communities. It is estimated that of the approximately 11.6 million people who are incarcerated within U.S. corrections facilities every year, 80% have chronic medical conditions that often go untreated and 68% have substance-use disorders, with roughly 15% of males and over 30% of females diagnosed with serious mental illness.
The unmet medication needs of this population represent a significant challenge to everyone involved in trying to provide the legally required level of care in the midst of ever-growing demands on the system due to budget and staffing constraints. To address these challenges, correction facilities have been exploring automated packaging and dispensing technology options and seeking partnerships with pharmacies that can provide services to improve patient safety while reducing waste and saving staff time.
According to Butler, receiving medications from the dispensing pharmacy is just the first step, and the challenges become more significant as these drugs are distributed to the inmates in need of care. “Dispensing requires knowledge of where the person is located within the institution, which can often change, and knowledge about the medication itself, its dosage, schedule, and course. In addition, inventory needs to be tracked, reconciled, and reordered. To perform these tasks, correctional institutions will often rely on multiple health information technology (health IT) solutions.”
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Published December 13, 2018